[The pathomorphology of acute drug-induced tubulointerstitial nephritis]

The author submits results of pathomorphologic study of 31 nephrobiopsies presenting with an acute drug-induced tubulointerstitial nephritis (ATIN). Antibiotics and non-steroidal antiinflammatory drug preparations appeared to be associated with the greatest drug-induced ATIN morbidity. The main ATIN pathomorphologic presentation includes focal inflammatory infiltration of the stroma and tubular walls, interstitial edema, dystrophy of the tubular epithelium and focal tubular necrosis. There have been identified the following four types of drug-induced ATIN depending upon the inflammatory infiltrate constitution: lymph-macrophagal, eosinophilic, plasmocytic, and granulomatous ATIN. Pathomorphologic changes are shown to be related to the time of performing a biopsy as well as to the particular features of the organism's reactivity rather than to the medicine administered.